14D0416053 CLIA NUMBER - KIRKLAND MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 14D0416053
  • Facility Name: KIRKLAND MEDICAL CLINIC
  • Facility Address: 406 S 5TH ST
    KIRKLAND, IL
    ZIP 60146
  • Facility Phone: 815 522-3301
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS L. MICHALSEN
  • NPI Number: 1679604151
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 14D0416053
LAB Type Physician Office
Facility Name KIRKLAND MEDICAL CLINIC
Street 406 S 5TH ST
City KIRKLAND
State IL
ZIP 60146
Phone 815 522-3301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director THOMAS L. MICHALSEN

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This page was last updated on: 9/29/2025